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Dr. Micah Boaz Edwin, MD
General Practice Physician in Lauderdale Lakes, Florida
NPI 1033430327

Micah Boaz Edwin is a General Practice Physician based in Ft Lauderdale, FL. Micah Boaz Edwin practices in Lauderdale Lakes, FL and has the professional credentials of MD. The NPI Number for Micah Boaz Edwin is 1033430327 and holds a License No. 261987 (Florida).

The current practice location address for Micah Boaz Edwin is 4850 W Oakland Park Blvd Ste 224, Lauderdale Lakes, FL and can be reached out via phone at 786-214-2001.

Location: 4850 W Oakland Park Blvd Ste 224, Lauderdale Lakes, FL, 33338-4067
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033430327
Provider Name
Micah Boaz Edwin
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4850 W Oakland Park Blvd Ste 224, Lauderdale Lakes, FL, 33338-4067
Phone Number
786-214-2001
Fax Number
Provider Enumeration Date
06/21/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4850 W Oakland Park Blvd Ste 224
City
Lauderdale Lakes
State
Florida
Zip
33313-7261
Phone Number
786-214-2001
Fax Number
person
Provider Business Mailing Address Details
Address
4850 W Oakland Park Blvd Ste 224
City
Lauderdale Lakes
State
Florida
Zip
33313-7261
Phone Number
786-214-2001
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
261987 (New York)
Definition
Definition to come...
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